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This study assessed the quantity and quality of food consumed by Australian Capital Territory and Perth women living in poverty from July to October 2017. Sixty-six women, recruited through charitable food organizations, participated in one-on-one interviews and 24-hr dietary recall. Overall, diet quality was poor. Daily energy intakes ranged between 96 kJ-11450 kJ. 75% of women consumed below the minimum energy requirement for their age. Daily serve recommendations and Estimated Average Requirements for calcium, iron and potassium were not met. Urgent action is needed from government, health, food, and community sectors to address the ongoing challenges faced by women experiencing food insecurity. [ABSTRACT FROM AUTHOR]

Tennis players' success relies on tennis skills, such as groundstrokes and serves, and physical attributes, such as strength, speed and endurance. This study aimed to determine if players' tennis skills and physical attributes are influenced by time of day, chronotype or sleep–wake behaviour (SWB). Twelve male tennis players (age (years): 28.17 ± 7.85) competing in state-level competitions wore a wrist-worn activity monitor (GT3X, Actigraph) and completed a modified version of the Consensus Sleep Diary to measure SWB. The Chalder Fatigue Scale and Morningness and Eveningness Questionnaire were used to measure players' fatigue and preferred chronotype. Mid-sleep with a sleep correction was used to determine players' current chronotype. After the baseline period, players were tested at 8:00 am, 2:00 pm and 8:00 pm, with the order of testing sessions randomised for each player. Testing sessions were separated by at least 48 hours. Players' groundstrokes, serve speed, agility, overhead medicine ball throw and Hit and Turn Test performance were measured in each session. General linear modelling revealed that backhand consistency was less in the evening compared to the morning by 17% (p = 0.020) and afternoon by 15% (p = 0.040). Maximal service velocity was less in the evening compared to the afternoon by 10.5 km/h (p = 0.041). Chronotype did not influence tennis skills or physical performance. Average and maximal backhand velocities were reduced for every hour that time at lights out, and sleep-onset time was postponed. Tennis skills, but not physical performance tests, were influenced by time of day and SWB. [ABSTRACT FROM AUTHOR]

Tennis match performance is often evaluated by a player's internal (heart rate) and external (match analytics) outcomes. Numerous factors could influence these outcomes, including the time of day, which may be advantageous or not depending on a player's chronotype. This study aimed to determine the influence time of day, chronotype and sleep–wake behaviour (SWB) had on internal and external outcomes of tennis matches. Twelve state-level male tennis players, with a mean age of 28 ± 7, stature of 183 ± 7 and body mass of 86.6 ± 17.4 wore an actigraph device and completed a sleep diary for the study duration. Based on rankings, players were paired against the same opponent and completed three tennis matches at 8:00 am, 2:00 pm and 8:00 pm, separated by a minimum of 48 h. Fatigue and chronotype, measured by the Fatigue Severity Scale, Morningness Eveningness Questionnaire and midsleep time, were assessed before matches; motivation, measured by the Intrinsic Motivation Inventory, was assessed after matches. During matches, players wore global positioning systems and heart rate monitors; the match analytics and players' rate of perceived exertion were recorded. Increased unforced errors and decreased winners and forced errors were observed in the evening matches. Decreased total distance and rate of perceived exertion during the second set were found for the evening compared to morning and afternoon matches. Chronotype and sleep–wake behaviour had trivial to weak associations with internal and external outcomes. These results indicate that players and coaches should consider the match times when training for future tournaments. [ABSTRACT FROM AUTHOR]

To establish the proportion of patients with retinitis pigmentosa (RP) meeting the Australian fitness to drive (FTD) visual standards. A prospective consecutive case series of patients with a clinical or genetic diagnosis of RP. Data on age at symptom onset, current driving status, inheritance pattern, better eye visual acuity (BEVA), binocular Esterman visual field (BEVF) parameters, genotype and ability to meet the driving standards based on BEVA and BEVF were collected. Outcome measures included the proportion of RP patients overall meeting the standards and clinical predictors for passing. A sub-analysis was performed on those RP patients who reported to drive. Change in BEVA and BEVF parameters across age in specific genotype groups was assessed. Overall, 228 patients with RP had a BEVF assessment. Only 39% (89/228) met the driving standards. Younger age at the time of testing was the only significant predictor (p < 0.01) for passing. Of the 55% of RP patients who reported to drive, 52% (65/125) met the standards, decreasing to 14% in the 56- to 65-year-old age group. RP patients harbouring mutations in HK1 or RHO genes may have slower rates of decline in their VF parameters. Nearly 40% of RP patients met the driving standards. However, almost 50% of RP drivers were unaware of their failure to meet the current standards. BEVF testing is essential in the assessment of RP patients who are still driving. Phenotype and genotype predictors for passing the standards warrant further investigation. Abbreviation: FTD, fitness to drive; IRD, inherited retinal disease; RP, retinitis pigmentosa; RHO, rhodopsin; HK1, hexokinase 1; PRPF31 pre-mRNA processing factor 31; RPGR, retinitis pigmentosa GTPase regulator; VF, visual field; BEVA, better eye visual acuity; BEVF, binocular Esterman visual field. [ABSTRACT FROM AUTHOR]

We aimed to compare the dietary intakes of Australian patients with non-alcoholic fatty liver disease (NAFLD) to general Australian population intake data and determine whether the intake of any nutrient or food group was able to predict the degree of steatosis. Dietary data from fifty adult patients with NAFLD were compared to intake data from the Australian Health Survey for energy, macronutrients, fat sub-types, alcohol, iron, folate, sugar, fibre, sodium and caffeine. Linear regression models adjusting for potential confounders (age, sex, physical activity and body mass index) were used to examine predictive relationships between hepatic steatosis (quantified via magnetic resonance spectroscopy) and dietary components. The mean percentage differences between NAFLD and Australian usual intakes were significant for energy, protein, total fat, saturated fat, monounsaturated and polyunsaturated fats (all p < 0.001). The contribution of fat and protein to total energy intake was significantly higher in the NAFLD cohort (p < 0.05). No individual nutrients or food groups were strongly related to hepatic fat in the adjusted models. Higher overall consumption appears to be a major feature of dietary intake in NAFLD when compared to the general population. A whole-diet approach to NAFLD treatment and prevention is likely to be more effective than focusing on single food components. [ABSTRACT FROM AUTHOR]

Introduction: Quality of life (QoL), mental wellbeing, and physical function are often diminished among people with chronic disease. Tai Chi is a moderate form of exercise that may be effective in improving chronic disease management. This protocol paper outlines a trial to determine the therapeutic effects of a Tai Chi program on chronic disease management. Methods and analysis: This study will be a pilot, interventional, single-blind, two-armed, randomised, parallel, and controlled trial involving a 12-week Tai Chi program for Australian adults. Forty people aged 18 years and older, diagnosed with one or more chronic disease from general community will be recruited. All participants will be randomised to either a 12-week Tai Chi program or a waiting list control group. The Tai Chi program will involve 12 weeks of group Tai Chi sessions, with 45 minutes per session, twice a week. The primary outcome will be QoL as measured by mean scores on the 12-item Short Form Health Survey (SF-12v2) and the EuroQoL (EQ-5D). The secondary outcomes will include anxiety as measured by mean score on the generalised anxiety disorder 7 (GAD-7) survey; depression as measured by mean score on the patient health questionnaire (PHQ-9); work productivity and activity assessment (WPAI:SHP); pain (if any) as measured by mean scores on the visual analogue scale (VAS) and the McGill pain questionnaire (MPQ). These primary and secondary outcomes will be self-administered via two online assessments prior to (T0) and post-intervention (T1). Objective measures as additional secondary outcomes, will also be carried out by the research team including flexibility as measured by the finger to floor distance (FFD); obesity as measured by mean scores on body mass index (BMI); vital signs (blood pressure, heart rate, respiratory rate, temperate, and oxygen saturation) as measured by a blood pressure monitor, tympanic, and pulse oximetry device, and these outcomes will be measured at T0 and T1 in the ECU Holistic Health Research Clinic. People diagnosed with pre-diabetes or diabetes, their glycosylated haemoglobin (HbA1C) and fasting (before breakfast) blood glucose level (BGL) will also be measured via test kits at T0 and T1 in the clinic. Linear mixed modelling will be conducted to assess changes in outcomes. Statistical significance will be set at an alpha level of 0.05 with a medium effect size. All analyses will be conducted using R version 4.1. Qualitative data will be analysed using template thematic analysis. Ethics and dissemination: Ethical approval has been obtained from the Edith Cowan University (ECU) Human Research Ethics Committee (2021-03042-WANG). Research findings will be disseminated to the public, health professionals, researchers, and healthcare providers through conference presentations, lay summaries, and peer-reviewed publications. This study will provide an updated evidence on a safe, sustainable, and inexpensive non-pharmacological approach in the management of chronic disease, the number one burden of disease in Australia. Trial registration: Trial registration number:ACTRN12622000042741p. [ABSTRACT FROM AUTHOR]

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Background: The nutrition care process (NCP) and its associated standardised terminology (NCPT, referred to collectively as NCP/T) forms a problem‐solving framework fundamental to dietetic practice. Global implementation would assist in confirming outcomes from dietetic care, but implementation rates have varied between countries. We investigated which factors predict NCP/T knowledge and use among dietetic professionals in an international cohort, aiming to understand how implementation can be strengthened. Methods: The validated International NCP Implementation Survey was disseminated to dietitians in 10 countries via professional networks. Implementation, attitudes and knowledge of the NCP/T along with workplace and educational data were assessed. Independent predictive factors associated with higher NCP/T knowledge and use were identified using backward stepwise logistic regression. Results: Data from 6149 respondents was used for this analysis. Enablers that were independent predictors of both high knowledge and frequent use of NCP/T were peer support, recommendation from national dietetic association and workplace requirements (all p < 0.001). Country of residence and working in clinical settings (p < 0.001) were demographic characteristics that were independent predictors of high knowledge and frequent use of NCP/T. A high knowledge score was an independent predictor of frequent NCP/T use (p = 0.002). Conclusions: Important modifiable enablers for NCP knowledge and use rely on organisational management. National dietetic organisations and key stakeholders such as employers are encouraged to integrate active NCP/T support in their leadership initiatives. This could take the form of policies, formalised and structured training strategies, and informatics initiatives for the integration in electronic health records. Key points: The nutrition care process (NCP) and its associated terminology comprises a problem‐solving framework central to modern dietetic practice.The present study used a validated questionnaire to investigate independent predictors of NCP knowledge and use in dietitians internationally.Although some predictors, such as recency of qualification, clinical work and country of residence are not easily modifiable, others are, including peer support, NCP use as workplace requirement and influence from national dietetic associations.National associations should commit to specific tactics that support the NCP such as evidence‐based training programs run by suitably qualified professionals. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has impacted the Australian food supply through changed consumer purchasing patterns, and potentially, household food security. The aim of this study was to determine the impact of COVID-19 on the prevalence of food insecurity and food supply issues, and perspectives of food supply stakeholders in regional Australia.Methods: A mixed-methods consumer survey and in-depth interviews with food supply stakeholders were conducted in regional Australia, more specifically South West Western Australia between May and July 2020, immediately after the 1st wave of the pandemic.Results: The prevalence of food insecurity was 21% among consumers, and significantly more prevalent for those aged less than 30 years and living with a disability. Most consumers (73%) agreed that the COVID-19 pandemic had impacted the food supply. Food insecure respondents were more likely to report that food was more expensive, resulting in changes to the types and quantities of food bought. Food supply stakeholders perceived that consumers increased their intention to buy locally grown produce. Panic buying temporarily reduced the availability of food for both food suppliers and consumers, regardless of their food security status.Conclusions: This study provided novel insights from South West Australian consumer and food supply stakeholder perceptions. Food insecure consumers provided insights about the high cost of food and the subsequent adaptation of their shopping habits, namely type and amount of food purchased. Stakeholder perceptions largely focused on supply chain issues and corroborated consumer reports. [ABSTRACT FROM AUTHOR]

Purpose: Anastomotic leak (AL) following ileocolic anastomosis is a cause of significant morbidity and mortality. Stapled end-to-side (ESA), stapled side-to-side (SSA), and handsewn anastomoses (HSA) are commonly performed techniques. There is however conflicting data on the superiority of one technique over the other. The aim of this study was to compare the outcomes of ESA against SSA and HSA. Methods: This retrospective cohort study was conducted at a tertiary colorectal unit. All patients who underwent an ileocolic anastomosis from October 2008 to May 2020 were included. Exclusion criteria were missing data on anastomotic technique or clinicopathological variables. Primary outcomes were AL and anastomotic bleeding (AB). Secondary outcomes were length of stay (LoS) and return of gut function. Results: A total of 1390 patients met the inclusion criteria. A total of 976 (70%) ESA, 308 (22%) SSA, and 108 (8%) HSA were performed. AL occurred in 17/1390 (1.2%) patients, and 54/1390 (3.9%) had AB. On adjusted analysis, ESA experienced a lower AL when compared with SSA (OR 4.93, p = 0.005), with a trend towards a lower AL when compared to HSA (OR 2.6, p = 0.27). There was no difference in AB between all techniques: ESA vs. SSA (OR 1.07 p = 0.84), and ESA vs. HSA (OR 0.24 p = 0.76). Both stapled techniques were associated with a shorter return to gut function compared to HSA; 3.3 vs. 4.2 days (p < 0.001). There was no difference in LoS. Conclusion: ESA has the lowest leak rate when compared to other anastomotic techniques without any increased risk of anastomotic bleeding. [ABSTRACT FROM AUTHOR]

Background: Shoulder and neck pain (SNP) is common in office workers and represents a serious public health problem given its detrimental impact on quality of life, physical functioning, personal finances, employers, and the health care system. Management with painkillers has adverse implications such as tolerance, addiction, and opioid abuse. Safe, sustainable, cost-effective, and evidence-based solutions are urgently needed. The non-invasive, painless, non-infectious, and safe modality of low-level laser acupuncture (LLLA) has shown promise for SNP management. Objective: The overarching aim of this study is to provide evidence of the feasibility and therapeutic efficacy of LLLA for office workers with SNP. Methods: This is a pilot, single-blind, double-armed, randomised controlled trial on the feasibility and therapeutic efficacy of a two-week LLLA therapy for office workers with SNP, aged 18 to 65 years. Each of the two study groups will contain 35 participants: the intervention group will receive LLLA from a licensed acupuncturist at the researchers' university clinic (10–20 min/session, 3 sessions/week) for two weeks; the control group will receive usual care without painkillers. Outcomes will be measured at baseline, throughout the two-week intervention, and at trial end. Surveys including open-ended questions will be completed. The primary outcome of this study is to evaluate the feasibility of a two-week LLLA therapy for office workers with SNP, as measured by recruitment and completion rates, patient safety, and treatment adherence and compliance. Participants' attitudes, motivation, and challenges to participation, intervention non-compliance, and experience of participating in the trial will be investigated via qualitative data. The secondary outcome is to evaluate the therapeutic efficacy of LLLA on SNP using the visual analogue scale (VAS) and the Short-Form McGill Pain Questionnaire (SF-MPQ); the work productivity and activity assessment (WPAI:SHP); 12-Item Short Form Survey (SF-12) for quality of life assessment; and the past 3-month out-of-pocket (OOP) cost for prescription and non-prescription SNP therapy, which is an indicative of the economic burden of SNP on patients and health care systems. This study was approved by Edith Cowan University's Human Research Ethics Committee (No. 2021-02225-WANG). Results: Data collection will commence in December 2021 with anticipated completion by December 2022. Conclusions: Safe, sustainable, cost-effective, evidence-based interventions are needed to minimise the negative implications of SNP in office workers. LLLA is a promising modality in managing SNP. However, more consolidated evidence is required to provide insight regarding the effectiveness of LLLA. This study is expected to contribute to the challenging work of reducing the burden of SNP in office workers. Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12621000426886p; https://www.anzctr.org.au/ACTRN12621000426886p.aspx [ABSTRACT FROM AUTHOR]

Background: Gestational Diabetes Mellitus (GDM) is prevalent with lasting health implications for the mother and offspring. Medical nutrition therapy is the foundation of GDM management yet achieving optimal glycaemic control often requires treatment with medications, like insulin. New dietary strategies to improve GDM management and outcomes are required. Gut dysbiosis is a feature of GDM pregnancies, therefore, dietary manipulation of the gut microbiota may offer a new avenue for management. Resistant starch is a fermentable dietary fibre known to alter the gut microbiota and enhance production of short-chain fatty acids. Evidence suggests that short-chain fatty acids improve glycaemia via multiple mechanisms, however, this has not been evaluated in GDM.Methods: An open-label, parallel-group design study will investigate whether a high dietary resistant starch intake or resistant starch supplement improves glycaemic control and changes the gut microbiome compared with standard dietary advice in women with newly diagnosed GDM. Ninety women will be randomised to one of three groups - standard dietary treatment for GDM (Control), a high resistant starch diet or a high resistant starch diet plus a 16 g resistant starch supplement. Measurements taken at Baseline (24 to 30-weeks' gestation), Day 10 and Day 56 (approximately 36 weeks' gestation) will include fasting plasma glucose levels, microbial composition and short-chain fatty acid concentrations in stool, 3-day dietary intake records and bowel symptoms questionnaires. One-week post-natal data collection will include microbial composition and short-chain fatty acid concentrations of maternal and neonatal stools, microbial composition of breastmilk, birthweight, maternal and neonatal outcomes. Mixed model analysis of variance will assess change in glycaemia and permutation-based multivariate analysis of variance will assess changes in microbial composition within and between intervention groups. Distance-based linear modelling will identify correlation between change in stool microbiota, short-chain fatty acids and measures of glycaemia.Discussion: To improve outcomes for GDM dyads, evaluation of a high dietary intake of resistant starch to improve glycaemia through the gut microbiome needs to be established. This will expand the dietary interventions available to manage GDM without medication.Trial Registration: Australian New Zealand Clinical Trial Registry, ACTRN12620000968976p . Registered 28 September 2020. [ABSTRACT FROM AUTHOR]

Issue addressed: Caregivers have a crucial role to play in keeping children safe at public swimming pool facilities, with the most common factor contributing to childhood drowning being a lapse in adult supervision. Methods: A mixed methods approach was used to collect observations (n = 301) and interviews (n = 10) with caregivers of children aged 0‐10 years at two public swimming pool facilities located in the Perth metropolitan area, Western Australia (WA). Results: Of the 449 children observed, children aged 6‐10 years were significantly less likely to be provided with ideal supervision (26%) compared to younger children aged 0‐5 years (62%). Of the caregivers who were using their mobile phone while supervising children (n = 100, 22% of children observed), none provided ideal supervision. Overall supervision levels among caregivers differed with gender, with only 44% (n = 74) of female caregivers providing ideal supervision, compared to 72% (n = 96) of male caregivers. The 10 interviews revealed several themes, including the following: caregivers' perceptions of their supervision responsibilities; barriers to supervision; and awareness and perceptions of a communications campaign designed by the Royal Life Saving WA Branch, known as Watch Around Water (WAW). Conclusion: Caregiver supervision at public swimming pools remains an important issue, particularly the use of mobile phones and its deleterious impact on supervision. The WAW program plays an integral role in educating caregivers of supervision responsibilities. Furthermore, this study adds to the limited evaluation of the WAW program, and thus will help guide future improvements to ensure caregiver supervision is consistent. So what?: Further research is needed to create strategies to reduce mobile phone use among caregivers, in order to provide safer swimming environments. [ABSTRACT FROM AUTHOR]

Issue addressed: Vulnerable populations are disproportionately affected by food insecurity, resulting in heightened risk of suboptimal dietary intake. Food insecure people appear to implement several coping strategies and dietary compromises to avoid hunger. Less explored in the literature is how these strategies impact consumption of food inside and outside of the home. Methods: An online survey was completed by adults (n = 1292) residing in one of five Australian states. The questionnaire comprised of the six‐item US Household Food Security Survey Module, 12 socio‐demographic variables and 32 questions related to elements of food literacy. Results: Food insecure respondents were more likely to frequent fast food vs (P =.002), takeaway (P <.001) and food courts (P <.001) than their food secure counterparts. Food secure respondents reported greater use of raw (P =.043) and fresh, pre‐prepared produce (P =.002) when cooking, whereas food insecure respondents were more likely to prepare food using only frozen, pre‐packaged products (P <.001). No significant differences were found between food security status and the enjoyment and social bonding derived from cooking. Conclusions: Food insecure respondents appeared to be accessing a poorer quality of food through greater consumption of takeaway and fast food. These dietary compromises are most likely related to perceived financial, time or cooking facility constraints and to a lesser extent food literacy skills. So what?: This study highlights some of the health and social inequities apparent within food insecure populations. Food insecure households should be supported to access healthy fresh food and in‐home cooking practices. While a multi strategy approach is required, healthy food environment policy, particularly in disadvantaged areas, should be considered to guarantee that all Australians have dignified access to nutritious food. [ABSTRACT FROM AUTHOR]

This study explored the association between autistic-like traits in young adults and dietary intake in early childhood in the Gen2 Raine Study cohort. Data were available from 811 participants at years 1, 2 and 3 for the assessment of dietary intake, and at year 20 for measurement of autistic-like traits. Results showed as autistic-like traits increased, total food variety, core food variety and dairy variety decreased (p < 0.05), with a lower consumption of citrus fruits and yoghurt (both p = 0.04). As autistic-like traits increased, diet quality decreased, this trend was significant at 2 years (p = 0.024). Our results suggest that young adults with higher autistic-like traits were more likely to have had lower food variety and diet quality in early childhood. [ABSTRACT FROM AUTHOR]

Shiftwork may adversely impact an individual's sleep-wake patterns and result in sleep loss (<6 h. following night shift), due to the circadian misalignment and the design of rosters and shifts. Within a mining operation, this sleep loss may have significant consequences due to fatigue, including an increased risk of accidents and chronic health conditions. This study aims to (i) determine the efficacy of an intervention that comprises a sleep education program and biofeedback through a smartphone app on sleep quality, quantity, and alertness (ii) determine the prevalence of risk for a potential sleep disorder, and (iii) quantify and describe the sleep habits and behaviors of shift workers in a remote mining operation. This study consists of a randomized controlled trial whereby eighty-eight shift workers within a remote mining operation are randomized to a control group or one of three different treatment groups that are: (i) a sleep education program, (ii) biofeedback on sleep through a smartphone app, or (iii) a sleep education program and biofeedback on sleep through a smartphone app. This study utilizes wrist-activity monitors, biomathematical modeling, and a survey instrument to obtain data on sleep quantity, quality, and alertness. A variety of statistical methods will determine the prevalence of risk for a potential sleep disorder and associations with body mass index, alcohol, and caffeine consumption. A generalized linear mixed model will examine the dependent sleep variables assessed at baseline and post-intervention for the control group and intervention groups, as well as within and between groups to determine changes. The findings from this study will contribute to the current understanding of sleep and alertness behaviors, and sleep problems and disorders amongst shift workers. Importantly, the results may inform fatigue policy and practice on interventions to manage fatigue risk within the mining industry. This study protocol may have a broader application in other shiftwork industries, including oil and gas, aviation, rail, and healthcare. [ABSTRACT FROM AUTHOR]

Evaluation of fisheries management and sustainability indicators can be supported by a reliable index of harvest rate. However, the most appropriate model that accounts for recreational fisheries is largely unknown. In order to adjust for these factors, generalized linear models were applied to data from shore-based recreational fishing surveys conducted in Western Australia between 2010 and 2016. Five candidate error distributions (lognormal, Gamma, Zero-Altered Gamma, Tweedie, and delta-lognormal) and seven independent variables (year, month, target species, fishing platform, fishers' avidity, time of day, and day type) were examined for commonly caught nearshore teleost species. Zero-Altered Gamma and Tweedie models performed best overall, although model performance and explanatory variables varied between species. Standardized harvest rates for Australian herring (Arripis georgianus) declined from 1.88 ± 0.17 (mean ± s.e.) fish per fishing party per day) in 2010 to 0.86 ± 0.07 in 2016, while harvest rates for School whiting (Sillago spp.) increased from 0.44 ± 0.21 in 2010 to 0.94 ± 0.34 in 2016. The standardized harvest rates for both species generally showed less fluctuation among years and consistently had smaller errors than the raw harvest rates. Overall, the results suggest that the choice of error distribution, as well as explanatory variables, is species dependent when assessing shore-based fisheries. The approach used could easily be adapted to other recreational fisheries to establish reliable species-specific harvest rates that can detect variability against thresholds set in harvest strategies. [ABSTRACT FROM AUTHOR]

Early parenthood can be stressful. Many parenting interventions emphasize skills training, as opposed to improving the parent-child relationship. We investigated whether the Respectful Approach intervention, based on building the parent-child relationship through observation and respect, improves stress and confidence in parents of infants and toddlers. Using a quasi-experimental design, we compared changes in self-reported levels of stress and parenting competence between 15 parents who attended the Respectful Approach parent-child classes (once a week for six weeks), to a control group of 23 parents utilizing the 'Parenting Sense of Competence Scale', 'Parental Stress Scale' and 'Depression Anxiety Stress Scales'. A focus group was held at the conclusion of the intervention to provide feedback about the classes. A significant Time × Group interaction was observed for both parent competence (p = 0.004) and parent stress (p = 0.010). Parents in the intervention group demonstrated a significant increase in parent competence (p = 0.001) with no significant change observed in the control group (p = 0.787). Parent stress significantly increased in the control group (p = 0.017) and marginally decreased in the intervention group (p = 0.134). Qualitative analysis revealed that the intervention parents felt they were calmer and better understood their children. These findings suggest that the Respectful Approach intervention may improve parental stress and parenting competence. Our results justify development of a randomized controlled trial to further quantify the effect of this approach. Highlights: We examined an early relationship-based parenting intervention (Respectful Approach) for parents of children under the age of two. Respectful Approach aims to improve parent stress and competence by helping parents view the child as a separate, competent being with their own thoughts and intentions, and to trust in the child's abilities. Parents of infants revealed they felt less stressed, while parents of toddlers felt more confident after participation in the intervention. Further research into the use of the Respectful Approach as a potential population-based support system is warranted. [ABSTRACT FROM AUTHOR]

Background: Recent findings suggest that individuals with Huntington's disease (HD) have an impaired capacity to execute cognitive and motor tasks simultaneously, or dual task, which gradually worsens as the disease advances. The onset and neuropathological changes mediating impairments in dual tasking in individuals with HD are unclear. The reliability of dual tasking assessments for individuals with HD is also unclear. Objectives: To evaluate differences in dual tasking performance between individuals with HD (presymptomatic and prodromal) and matched controls, to investigate associations between striatal volume and dual tasking performance, and to determine the reliability of dual tasking assessments. Methods: Twenty individuals with HD (10 presymptomatic and 10 prodromal) and 20 healthy controls were recruited for the study. Individuals undertook four single and dual task assessments, comprising motor (postural stability or force steadiness) and cognitive (simple or complex mental arithmetic) components, with single and dual tasks performed three times each. Participants also undertook a magnetic resonance imaging assessment. Results: Compared to healthy controls, individuals with presymptomatic and prodromal HD displayed significant deficits in dual tasking, particularly cognitive task performance when concurrently undertaking motor tasks (P < 0.05). The observed deficits in dual tasking were associated with reduced volume in caudate and putamen structures (P < 0.05),however, not with clinical measures of disease burden. An analysis of the reliability of dual tasking assessments revealed moderate to high test–retest reliability [ICC: 0.61‐0.99] for individuals with presymptomatic and prodromal HD and healthy controls. Conclusions: Individuals with presymptomatic and prodromal HD have significant deficits in dual tasking that are associated with striatal degeneration. Findings also indicate that dual tasking assessments are reliable in individuals presymptomatic and prodromal HD and healthy controls. [ABSTRACT FROM AUTHOR]

Background: The Paleolithic diet is promoted worldwide for improved gut health. However, there is little evidence available to support these claims, with existing literature examining anthropometric and cardiometabolic outcomes. Objective: To determine the association between dietary intake, markers of colonic health, microbiota, and serum trimethylamine-N-oxide (TMAO), a gut-derived metabolite associated with cardiovascular disease. Design: In a cross-sectional design, long-term (n = 44, > 1 year) self-reported followers of a Paleolithic diet (PD) and controls (n = 47) consuming a diet typical of national recommendations were recruited. Diets were assessed via 3-day weighed diet records; 48-h stool for short chain fatty acids using GC/MS, microbial composition via 16S rRNA sequencing of the V4 region using Illumina MiSeq. TMAO was quantified using LC–MS/MS. Results: Participants were grouped according to PD adherence; namely excluding grains and dairy products. Strict Paleolithic (SP) (n = 22) and Pseudo-Paleolithic (PP) (n = 22) groups were formed. General linear modelling with age, gender, energy intake and body fat percentage as covariates assessed differences between groups. Intake of resistant starch was lower in both Paleolithic groups, compared to controls [2.62, 1.26 vs 4.48 g/day (P < 0.05)]; PERMANOVA analysis showed differences in microbiota composition (P < 0.05), with higher abundance of TMA-producer Hungatella in both Paleolithic groups (P < 0.001). TMAO was higher in SP compared to PP and control (P < 0.01), and inversely associated with whole grain intake (r = − 0.34, P < 0.01). Conclusions: Although the PD is promoted for improved gut health, results indicate long-term adherence is associated with different gut microbiota and increased TMAO. A variety of fiber components, including whole grain sources may be required to maintain gut and cardiovascular health. Clinical trial registrations: Australian and New Zealand Clinical Trial Registry (ANZCTRN12616001703493). [ABSTRACT FROM AUTHOR]

Background: Australia, like other nations, has experienced a shift in dietary patterns away from home cooking of nutritious foods, towards a reliance on pre-prepared convenience meals. These are typically energy-dense, nutrient-poor and contribute to the rising prevalence of obesity and chronic disease burden. The aims of this study were to evaluate whether a community-based cooking program instigated a change to participants' skills, attitudes, knowledge, enjoyment and satisfaction of cooking and cooking confidence (self-efficacy).Methods: The pseudo-random, pre-post study design consisted of an intervention and a control group. Participant recruitment and group allocation was based on their program start dates. Intervention participants were surveyed three times (baseline, 7 weeks and 6 months) and the control group were surveyed at baseline and 5 weeks. All participants were registered via an online website and were 18 years or over. Upon consent, participants were offered four levels of commitment, defined by different assessments. The minimum participation level included an online survey and levels 2, 3 and 4 involved attendance at a clinic with increasing functional, anthropometric and biomarker measurements. Primary endpoints were participants' cooking confidence as a proxy for self-efficacy. Secondary endpoints were dietary intake, physical activity levels, body composition, anthropometry, blood, urine and faecal biomarkers of systemic, physical and mental health.Discussion: The community cooking program provided participants with information and advice on food sourcing, preparation and nutrition to improve home cooking skills. The study was designed to explore whether food literacy programs are efficacious in improving participant physical health and well-being in order to combat the rise in obesity and diet-related disease. It will support future use of public health cooking program initiatives aimed at improving food literacy, self-efficacy and physical and mental health. The extensive data collected will inform future research into the relationship between diet, the gut-microbiota and human health.Trial Registration: Retrospectively registered on 16.08.2019 with the Australian New Zealand Clinical Trials Registry (ANZCTR). ACTRN12619001144101 . Protocol version 4. [ABSTRACT FROM AUTHOR]

Background: Intraoperative nerve monitoring (IONM) has increasingly been used in thyroid surgery by general, endocrine and head and neck surgeons. The purpose of this paper was to explore the prevalence and reasons for the usage of IONM in endocrine surgery in Australia and New Zealand. Methods: A survey was sent to general surgeons registered with the Royal Australasian College of Surgeons involved in endocrine surgery and members of the Australian and New Zealand Endocrine Surgeons. Users were divided into surgeon type, area of work, hospital type and volume of surgery. These data were analysed with univariate and multivariate logistic regression models. Results: Significant differences in IONM usage levels were observed between endocrine and general surgeons, area of work and volume of surgery performed. Endocrine surgeons are significantly more likely to use IONM than general surgeons. Surgeons who work in tertiary hospitals are more likely to use IONM as compared to those working in district hospitals. Surgeons who perform less than 100 thyroidectomies were more likely to be users of IONM. Conclusion: IONM is not routinely used in thyroid surgery in Australia and New Zealand. The main reasons for the use of IONM given in our study by routine users were to establish familiarity of equipment and medicolegal reasons. Selective users chose as the most common reasons, a documented pre‐existing unilateral nerve paresis or a hostile surgical field. Non‐users stated that there was conflicting evidence that it improves outcomes and increased costs. [ABSTRACT FROM AUTHOR]

Background and Aim: Severe ulcerative colitis (UC) is potentially life threatening and is associated with significant morbidity. TNF‐∝ inhibitors (Infliximab) were introduced in Australia for the management of medically resistant, acute, severe flares of UC in 2008. The aim of this study is to assess the efficacy of Infliximab in preventing emergent and emergency colectomies for patients with moderate to severe UC by comparing colectomy rates before and after its introduction at our institution. Methods: This was a retrospective cohort study of all patients who were admitted to the Royal Perth Hospital with a flare of UC between 2002 and 2017. Patients were divided into two cohorts: those admitted prior to the introduction of Infliximab (pre‐2008) and those admitted after. We compared data between these two groups, including age, gender, length of admission, use of Infliximab, colectomy, and complications of surgery. We defined emergency surgery as requiring surgery during the index admission and emergent surgery as an operation within 54 weeks. Results: A total of 313 UC cases from 2002 to 2017 were analyzed. There was a decrease in emergency and emergent colectomies from 19.4 to 8% in the post‐2008 cohort (P = 0.008). Furthermore, there was a decrease in the proportion of operations performed as emergencies, from 36 to 20%. This resulted in a significantly reduced length of stay (13.4–9.7 days, P < 0.05) and complication rate (36 to 20%, P < 0.05). Conclusion: Overall, the need for emergency and emergent operations has drastically reduced at our institution with the introduction of Infliximab. This study has confirmed the efficacy of Infliximab in reducing colectomy rates at our institution. [ABSTRACT FROM AUTHOR]

Background: PD‐1 inhibitors are routinely used for the treatment of advanced melanoma. This study sought to determine whether PD‐L1 expression on circulating tumor cells (CTCs) can serve as a predictive biomarker of clinical benefit and response to treatment with the PD‐1 inhibitor pembrolizumab. Methods: Blood samples were collected from patients with metastatic melanoma receiving pembrolizumab, prior to treatment and 6–12 weeks after initiation of therapy. Multiparametric flow cytometry was used to identify CTCs and evaluate the expression of PD‐L1. Results: CTCs were detected in 25 of 40 patients (63%). Patients with detectable PD‐L1+ CTCs (14/25, 64%) had significantly longer progression‐free survival (PFS) compared with patients with PD‐L1− CTCs (26.6 months vs. 5.5 months; p =.018). The 12‐month PFS rates were 76% versus 22% in the PD‐L1+ versus PD‐L1− CTCs groups (p =.012), respectively. A multivariate linear regression analysis confirmed that PD‐L1+ CTC is an independent predictive biomarker of PFS (hazard ratio, 0.229; 95% confidence interval, 0.052–1.012; p =.026). Conclusion: Our results reveal the potential of CTCs as a noninvasive real‐time biopsy to evaluate PD‐L1 expression in patients with melanoma. PD‐L1 expression on CTCs may be predictive of response to pembrolizumab and longer PFS. Implications for Practice: The present data suggest that PD‐L1 expression on circulating tumor cells may predict response to pembrolizumab in advanced melanoma. This needs further validation in a larger trial and, if proven, might be a useful liquid biopsy tool that could be used to stratify patients into groups more likely to respond to immunotherapy, hence leading to health cost savings. The objective of this study was to determine whether PD‐L1 expression on circulating tumor cells can serve as a predictive biomarker of clinical benefit and response to treatment with the PD‐1 inhibitor pembrolizumab. [ABSTRACT FROM AUTHOR]

Aim: Many dietitians are yet to incorporate the Nutrition Care Process and Terminology (NCPT) into practice. The present study investigated factors predicting (i) NCPT use, (ii) perceived importance of NCPT implementation and (iii) perceived NCPT applicability to personal dietetic practice among dietitians in the Asia‐Pacific region. Methods: Dietetic association members from Australia, New Zealand and Singapore were invited to participate in an online survey assessing NCPT implementation, knowledge, and self‐rated familiarity, attitudes, benefits, concerns, barriers, and enablers. Forward stepwise logistic regression used all factors to identify predictive dietetic characteristics for current NCPT use, importance or applicability to practice. Results: A total of 377 dietitians (5%–55% of national dietetic memberships surveyed) completed at least one survey question. In logistic regression models, independent positive predictors of current NCPT users were knowledge (P = 0.003), confidence to implement (P = 0.036), confidence to write nutrition diagnoses (P = 0.002) and experiencing managerial support (P = 0.004). Not seeing a reason to change was a significant negative predictor of NCPT use (P = 0.003). An independent positive predictor of dietitians viewing NCPT implementation as important was feeling that it will improve patient care (P < 0.001), while negative predictors were seeing minimal benefit in changing (P < 0.001) and a preference to continue with current routine (P = 0.015). Independent positive predictors of dietitians viewing NCPT as applicable to their practice were NCPT knowledge (P = 0.009), seeing the value of NCPT (P < 0.001) and attendance at workshops or conferences (P = 0.014). Conclusions: NCPT implementation may be enhanced thorough activities building confidence, gaining managerial corroboration and demonstration of NCPT benefits, including improved patient care. [ABSTRACT FROM AUTHOR]

The Paleolithic diet excludes two major sources of fibre, grains and legumes. However, it is not known whether this results in changes to resistant starch (RS) consumption. Serum trimethylamine- N -oxide (TMAO) is produced mainly from colonic fermentation and hepatic conversion of animal protein and is implicated in CVD, but changes in RS intake may alter concentrations. We aimed to determine whether intake of RS and serum concentrations of TMAO varied in response to either the Paleolithic or the Australian Guide to Healthy Eating (AGHE) diets and whether this was related to changes in food group consumption. A total of thirty-nine women (mean age 47 (sd 13) years, BMI 27 (sd 4) kg/m2) were randomised to AGHE (n 17) or Paleolithic diets (n 22) for 4 weeks. Serum TMAO concentrations were measured using liquid chromatography–MS; food groups, fibre and RS intake were estimated from weighed food records. The change in TMAO concentrations between groups (Paleolithic 3·39 μ m v. AGHE 1·19 μ m , P = 0·654) did not reach significance despite greater red meat and egg consumption in the Paleolithic group (0·65 serves/d; 95 % CI 0·2, 1·1; P <0·01, and 0·22 serves/d; 95 % CI 0·1, 0·4, P <0·05, respectively). RS intake was significantly lower on the Paleolithic diet (P <0·01) and was not associated with TMAO concentrations. However, the limited data for RS and the small sample size may have influenced these findings. While there were no significant changes in TMAO concentrations, increased meat consumption and reduced RS intake warrant further research to examine the markers of gastrointestinal health of Paleolithic diet followers and to update Australian food databases to include additional fibre components. [ABSTRACT FROM AUTHOR]

Serum branched chain amino acids and trimethylamine-N-oxide are monitored as potential indicators of diabetes and cardiovascular health respectively. A rapid method for their simultaneous determination using liquid chromatography and tandem mass spectrometry is described here. Branched chain amino acids and trimethylamine-N-oxide were quantified based on their specific MS/MS fragments using a selected reaction monitoring approach. A number of columns were tested for their ability to separate the analytes. A C18-PFP column separated the analytes in just 4 minutes, and resulted in excellent peak shape and retention time repeatability, and was therefore chosen as the optimal column. A second column, the Intrada Amino Acid column, was chosen for comparison and validation experiments as it provided an orthogonal separation mechanism. The intra-day and inter-day precision and accuracy were less than 12% for trimethylamine-N-oxide and less than 6% for the branched chain amino acids. Recoveries, where serum was spiked with three different concentrations of the analytes, ranged from 97 to 113%. The LODs and LOQs for trimethylamine-N-oxide were 1 and 6 ng/mL, for leucine and isoleucine were 4 and 8 ng/mL, and for valine were 5 and 15 ng/mL, respectively. The C18-PFP column method was validated using the Intrada Amino Acid column method and percentage agreement for all four analytes was within 10%. Sample preparation was minimal, and use of labelled internal standards accounted for matrix effects. The method was successfully applied to human plasma samples.ᅟ [ABSTRACT FROM AUTHOR]

This article provides methodological guidance to researchers wishing to develop collaborative research projects with local governments and other agencies, by describing the process adopted in a mixed methods study conducted in the City of Wanneroo (the City), a local government area in Perth, Western Australia. The study explored factors related to older people's (60+ years) participation in community-based activities and links between their participation and levels of social isolation, loneliness, and social connectedness. The research incorporated four interrelated stages: (1) an audit of existing programs in the City and program participant characteristics; (2) focus groups with program participants and interviews with nonparticipants; (3) a cross-sectional survey to assess factors associated with participation and links to social isolation, loneliness, and social connectedness; (4) face-to-face interviews with survey respondents screened at risk for loneliness. Methodological recommendations are provided to guide future collaborative research with local authorities, program developers, and administrators, aimed at minimizing social isolation and loneliness among older people. These include the need for clear communication and documentation of mutually agreed research objectives and responsibilities from project initiation to completion, identifying and working with local agencies to maximize recruitment among "hard to reach" groups, understanding the dimensions of loneliness addressed in the selected instrument used to screen for loneliness, and integrating innovative data collection techniques when working with vulnerable groups such as socially isolated older people. [ABSTRACT FROM AUTHOR]

Issue Addressed: Currently, two food sufficiency questions are utilised as a proxy measure of national food security status in Australia. These questions do not capture all dimensions of food security and have been attributed to underreporting of the problem. The purpose of this study was to investigate food security using the short form of the US Household Food Security Survey Module (HFSSM) within an Australian context; and explore the relationship between food security status and multiple socio-demographic variables.Methods: Two online surveys were completed by 2334 Australian participants from November 2014 to February 2015. Surveys contained the short form of the HFSSM and twelve socio-demographic questions. Cross-tabulations chi-square tests and a multinomial logistic regression model were employed to analyse the survey data.Results: Food security status of the respondents was classified accordingly: High or Marginal (64%, n = 1495), Low (20%, n = 460) or Very Low (16%, n = 379). Significant independent predictors of food security were age (P < 0.001), marital status (P = 0.005), household income (P < 0.001) and education (P < 0.001).Conclusion: Findings suggest food insecurity is an important issue across Australia and that certain groups, regardless of income, are particularly vulnerable. SO WHAT?: Government policy and health promotion interventions that specifically target "at risk" groups may assist to more effectively address the problem. Additionally, the use of a multi-item measure is worth considering as a national indicator of food security in Australia. [ABSTRACT FROM AUTHOR]

Objective: The primary objective of this trial was to evaluate the effects of outpatient multidisciplinary therapy, compared to usual care, on measures of physical function and muscle strength in patients with manifest Huntington's disease (HD). Methods: Twenty‐two patients with clinically verified HD were randomized to receive 36 weeks of outpatient multidisciplinary therapy or usual care. Outpatient multidisciplinary therapy comprised 9 months of supervised exercise, cognitive therapy and self‐directed home‐based exercise. Usual care consisted of standard medical care. Patients were assessed at 0 and 36 weeks by blinded assessors. The primary outcome was changed in mobility as measured by the 10‐m Timed Walk Test. Secondary outcome measures included changes in manual dexterity (Timed Nut and Bolt Test), balance (Berg Balance Scale), cardiorespiratory endurance (6‐Minute Walk Test) and upper and lower extremity muscle strength (isokinetic and isometric muscle strength and 10 Repetition Sit‐to‐Stand Tests). Results: Patients receiving outpatient multidisciplinary therapy demonstrated significantly enhanced manual dexterity (P < 0.05) and lower extremity muscle strength (P < 0.05) than patients receiving usual care. No significant differences in mobility, balance, cardiorespiratory endurance and upper extremity strength outcomes were observed between groups after the intervention period. There were no adverse events associated with multidisciplinary therapy. Conclusion: Our findings suggest that outpatient multidisciplinary therapy has positive effects on manual dexterity and muscle strength, but no meaningful effects on mobility, balance, cardiorespiratory endurance and upper extremity muscle strength in patients with HD. Larger randomized controlled trials are needed to confirm these preliminary findings. [ABSTRACT FROM AUTHOR]

Objectives: To assess the prevalence and correlates of psychological distress in a sample of remote mining and construction workers in Australia. Design, setting: A cross-sectional, anonymous Wellbeing and Lifestyle Survey at ten mining sites in South Australia and Western Australia, administered at meetings held during 2013-2015.Participants: 1124 employees at remote construction, and open cut and underground mining sites completed the survey.Main Outcome Measures: General psychological distress (Kessler Psychological Distress Scale, K10) and self-reported overall mental health status; work, lifestyle and family factors correlated with level of psychological distress.Results: The final sample comprised 1124 workers; 93.5% were men, 63% were aged 25-44 years. 311 respondents (28%) had K10 scores indicating high/very high psychological distress, compared with 10.8% for Australia overall. The most frequently reported stressors were missing special events (86%), relationship problems with partners (68%), financial stress (62%), shift rosters (62%), and social isolation (60%). High psychological distress was significantly more likely in workers aged 25-34 years (v ≥ 55 years: odds ratio [OR], 3.2; P = 0.001) and workers on a 2 weeks on/1 week off roster (v 4 weeks on/1 week off: OR, 2.4; P < 0.001). Workers who were very or extremely stressed by their assigned tasks or job (OR, 6.2; P = 0.004), their current relationship (OR, 8.2; P < 0.001), or their financial situation (OR, 6.0; P < 0.001) were significantly more likely to have high/very high K10 scores than those not stressed by these factors. Workers who reported stress related to stigmatisation of mental health problems were at the greatest risk of high/very high psychological distress (v not stressed: OR, 23.5; P < 0.001).Conclusions: Psychological distress is significantly more prevalent in the remote mining and construction workforce than in the overall Australian population. The factors that contribute to mental ill health in these workers need to be addressed, and the stigma associated with mental health problems reduced. [ABSTRACT FROM AUTHOR]

Issue addressed Little is known about the fruit and vegetable (F&V) habits of regional and remote Western Australian (WA) children beyond quantities consumed. This study aimed to ascertain the proportion of regional and remote WA children who met the Australian Dietary Guidelines (ADG) for F&V; the types and varieties of F&V consumed; and whether consumption behaviour was associated with remoteness. Methods Caregiver and child dyads (n=256 dyads) completed similar paper-based surveys, 196 of these children completed 24-h dietary records. Statistical analyses were conducted using IBM SPSS (version 23). Results Overall, children were less likely to adhere to vegetables (15.4%) than fruit (65.8%) guidelines. Adherence to the ADG did not significantly differ between regional and remote locations. However, a higher proportion of remote children consumed dried fruit compared with regional children, while significantly more regional children compared with remote children consumed from the 'pome, tropical and stone fruit' group and the 'starchy vegetables', 'red/orange vegetables' and 'dark green leafy vegetables' groups. Conclusions Many regional and remote WA children consumed F&V in suboptimal amounts. Further research should aim to ascertain factors that increase or decrease the likelihood of ADG adherence across regional and remote WA and determine why certain F&V variety groups and types differed in consumption across Remoteness Areas. So what This study provided closer scrutiny of WA children's F&V consumption habits, highlighting the differences in consumption behaviours due to remoteness and identifying specific areas that require further investigation. [ABSTRACT FROM AUTHOR]

Objectives This qualitative study explored the barriers and enablers influencing Western Australian ( WA) community pharmacists' knowledge, confidence, willingness and practice in engaging older clients (>60 years) in alcohol-related health discussions. Methods Two focus groups were conducted with a total of 14 community pharmacists who had previously completed a formative quantitative survey ( n = 63), and indicated willingness to participate in a follow-up focus group. Focus group questions, informed by the survey results, explored participants' perceptions about barriers and enablers to delivering health information and advice about alcohol to older clients (60+ years). Shaw and colleagues' theoretical framework was used to understand barriers and enablers in relation to role legitimacy, role adequacy and role support. Key findings Participants acknowledged that providing health information about alcohol to older clients is a legitimate part of a community pharmacist's role, and most were confident performing this role in situations perceived as core to their professional practice, such as while dispensing medicines. However, many participants identified limited knowledge, skills and confidence in assisting older clients who may have alcohol issues, beyond advising them on medication and alcohol use. Structural barriers such as time and financial barriers were also identified. Conclusion Routine professional practice including dispensing medicine and home medicine reviews may provide valuable opportunities to engage older clients in alcohol-related discussions. However, limited knowledge concerning appropriate strategies to assist older clients reduce their alcohol consumption, coupled with limited skills and confidence among community pharmacists in raising sensitive alcohol-related issues with clients, suggest the need for specific alcohol-related training and support. [ABSTRACT FROM AUTHOR]

Objectives This research aimed to identify older Australian drinkers' knowledge about Australian Alcohol Guidelines and their beliefs about the risks and benefits of alcohol; their recall of alcohol-related issues being raised with them by their community pharmacist and General Practitioner (GP); and their receptiveness to alcohol-related information being provided by either health professional. Methods This research was conducted in Perth, Western Australia. Flyers calling for participants were placed in local health and service centres, and advertisements were placed in local media. Participants who met eligibility requirements were posted a survey pack ( n = 190) including an information letter, consent form, quantitative survey, and return addressed, postage paid envelope. 188 people aged over 60 years returned completed questionnaires. Key findings Women were more familiar with national alcohol guidelines, and were more conservative about the potential health benefits of alcohol. While 90% of participants were receptive to their GP asking about their alcohol use, only 30% of men and 20% of women recalled their GP raising this issue with them in the prior 12 months. Of these, high-risk drinkers were six times more likely than low-risk drinkers to have been asked by their GP. Likewise, 50% of men and 65% of women were receptive to having alcohol-related health conversations with their community pharmacist, but less than 4% recalled their pharmacist raising this issue. Participants were most receptive to receiving information about alcohol-medication interactions. Conclusions This research highlights that prescribing and dispensing medication represents the ideal opportunity for health professionals to deliver alcohol-related information to older people. [ABSTRACT FROM AUTHOR]

(1) Background/Objectives: The Paleolithic diet has been receiving media coverage in Australia and claims to improve overall health. The diet removes grains and dairy, whilst encouraging consumption of fruits, vegetables, meat, eggs and nuts. Our aim was to compare the diet to the Australian Guide to Healthy Eating (AGHE) in terms of compliance, palatability and feasibility; (2) Subjects/Methods: 39 healthy women (age 47 ± 13 years, BMI 27 + 4 kg/m²) were randomised to an ad-libitum Paleolithic (n = 22) or AGHE diet (n = 17) for 4-weeks. A food checklist was completed daily, with mean discretionary consumption (serves/day) calculated to assess compliance. A 12-item questionnaire was administered post intervention to assess palatability and feasibility; (3) Results: The AGHE group reported greater daily consumption of discretionary items (1.0 + 0.6 vs. 0.57 + 0.6 serves/day, p = 0.03). Compared to the AGHE group, the Paleolithic group reported a significantly greater number of events of diarrhoea (23%, 0%, p = 0.046), costs associated with grocery shopping (69%, 6% p < 0.01) and belief that the diet was not healthy (43%, 0% p < 0.01); (4) Conclusions: Compliance to both diets was high but the potential side effects and increased cost suggest that the Paleolithic diet may not be practical in clinical/public health settings. Further studies are required to assess longer term feasibility. [ABSTRACT FROM AUTHOR]

(1) Background: The Paleolithic diet is popular in Australia, however, limited literature surrounds the dietary pattern. Our primary aim was to compare the Paleolithic diet with the Australian Guide to Healthy Eating (AGHE) in terms of anthropometric, metabolic and cardiovascular risk factors, with a secondary aim to examine the macro and micronutrient composition of both dietary patterns; (2) Methods: 39 healthy women (mean ± SD age 47 ± 13 years, BMI 27 ± 4 kg/m2) were randomised to either the Paleolithic (n = 22) or AGHE diet (n = 17) for four weeks. Three-day weighed food records, body composition and biochemistry data were collected pre and post intervention; (3) Results: Significantly greater weight loss occurred in the Paleolithic group (−1.99 kg, 95% CI −2.9, −1.0), p < 0.001). There were no differences in cardiovascular and metabolic markers between groups. The Paleolithic group had lower intakes of carbohydrate (−14.63% of energy (E), 95% CI −19.5, −9.7), sodium (−1055 mg/day, 95% CI −1593, −518), calcium (−292 mg/day 95% CI −486.0, −99.0) and iodine (−47.9 μg/day, 95% CI −79.2, −16.5) and higher intakes of fat (9.39% of E, 95% CI 3.7, 15.1) and β-carotene (6777 μg/day 95% CI 2144, 11410) (all p < 0.01); (4) Conclusions: The Paleolithic diet induced greater changes in body composition over the short-term intervention, however, larger studies are recommended to assess the impact of the Paleolithic vs. AGHE diets on metabolic and cardiovascular risk factors in healthy populations. [ABSTRACT FROM AUTHOR]

Proper dynamic modelling of the troposphere wet delay using the Global Navigation Satellite Systems (GNSS) measurements is important in precise point positioning and in estimation of the PrecipitableWater Vapour (PWV) for weather forecast. The random walk (RW) and the first-order Gauss-Markov (GM) autocorrelation models are commonly used for this purpose. However, it was found that these models consistently underestimate the temporal correlations that exist among the troposphere wet delay. Therefore, a new dynamic model is proposed. The performance of the proposed model in following the autocorrelation of actual data is demonstrated and its impact on the near-real time estimation of the wet delay was tested and compared to that of the GMand RWmodels. Results showed that the proposed model outperformed these models. When the computed wet delays were used to compute PWV, their estimated valueswere very close to actual PWV data measured by radiosonde with differences less than 1 mm. [ABSTRACT FROM AUTHOR]

Ventilation and pollutant transport in urban areas are major research problems nowadays due to the large number of urban inhabitants. However, our understanding of the street-level transport processes is rather limited because of the highly complicated urban morphology. This paper is thus conceived, using both laboratory wind tunnel measurements and computational fluid dynamics (CFD), to examine the pollutant transport behaviors from the ground level of idealized two-dimensional (2D) urban street canyons to the urban atmospheric boundary layer (ABL). Movable rectangular aluminum blocks are placed in the wind tunnel in cross-flow to construct street canyons of different building-height-to-street-width (aspect) ratios. The wind tunnel and CFD results complement each other to elucidate the pollutant removal mechanism that is in line with other results available in literature. From the experimental results obtained in this study, noticeable scaling effects are observed in the mass transfer behaviors even the flows have fulfilled kinematic similarity. Under this circumstance, a new indicator for pollutant removal, the scaled overall pollutant removal coefficient, is formulated for the assessment of pollutant removal performance. The accuracy of the new indicator is compared with our CFD results that shows an improved agreement. The newly proposed indicator could be used to account for the scaling effects occurred in laboratory experiments at finite Reynolds number (10 to 10 in this study) for comparison of pollutant removal performance in a more reasonable manner. [ABSTRACT FROM AUTHOR]

Most stochastic modelling techniques neglect the correlations among the raw un-differenced observations when forming the variance–covariance matrix of the Global Navigation Satellite System (GNSS) observations. Some methods were developed to model these correlations. One such method is the Minimum Norm Quadratic Unbiased Estimator (MINQUE). Studies have shown that MINQUE improves ambiguity resolution, and ultimately, the positioning solution in short baselines. However, its effect in cases of processing with longer baselines and on the estimation of zenith wet delay (ZWD) is somewhat unknown. In this paper, a comparison between the impact of neglecting the correlations among the observations using an elevation-angle-dependent model (EADM) and modelling the correlations using MINQUE on height determination and ZWD for medium and long baselines is carried out. The initial testing was carried out across two Australian GNSS stations with a medium-length baseline throughout a three-week campaign. The results showed that using MINQUE did not resolve the coordinate, height and wet delay components as accurately as the EADM. The results were further verified with two long-baseline campaigns whereby EADM was also able to provide better wet delay estimates. The coordinate results were, however, mixed. Overall, the study concluded that the inclusion of the correlations among the observations, in general, do not improve the resolution of the coordinate and wet delay estimates. [ABSTRACT FROM PUBLISHER]

The wet delay is one of the most difficult sources of error to quantify in global navigation satellite systems (GNSS) due to its spatial and temporal variability. However, its estimation is vital in some applications, such as in Precise Point Positioning (PPP), network real-time kinematic and weather forecast. Such estimation is usually carried out for its projected component along the zenith, defined as the zenith wet delay (ZWD). Prediction of the ZWD is important if there is a break in its estimation, and in providing initial values for future processing. In this paper, prediction modeling for the ZWD is investigated. An autocorrelation study was first performed on ZWD data over three different days at the international GNSS service station ONSALA to provide an insight into the temporal correlations among ZWDs. The choice of this station was based on the availability of reliable ZWD data measured by water vapor radiometers, which provide a reference for assessment of the accuracy of predicted values. Results have shown that successive ZWD estimates are significantly correlated for up to 1.7 hours. Different trend and smoothing prediction models were then investigated. Since prediction of ZWD requires continuous data sequence, interpolation methods of possible missing ZWD values are discussed. The use of linear interpolation or a cubic Hermite polynomial was found to be sufficient for interpolation of ZWD. Test results of prediction models show that the single-exponential smoothing model was the best performer where ZWD estimates were forecasted with a root mean square error of less than 1 cm for up to two hours. [ABSTRACT FROM AUTHOR]

Reported growth rates (GR) of atrophic lesions in Stargardt disease (STGD1) vary widely. In the present study, we report the longitudinal natural history of patients with confirmed biallelic ABCA4 mutations from five genotype groups: c.6079C>T, c.[2588G>C;5603A>T], c.3113C>T, c.5882G>A and c.5603A>T. Fundus autofluorescence (AF) 30° × 30° images were manually segmented for boundaries of definitely decreased autofluorescence (DDAF). The primary outcome was the effective radius GR across five genotype groups. The age of DDAF formation in each eye was calculated using the x-intercept of the DDAF effective radius against age. Discordance between age at DDAF formation and symptom onset was compared. A total of 75 eyes from 39 STGD1 patients (17 male [44%]; mean ± SD age 45 ± 19 years; range 21–86) were recruited. Patients with c.3113C>T or c.6079C>T had a significantly faster effective radius GR at 0.17 mm/year (95% CI 0.12 to 0.22; p < 0.001 and 0.14 to 0.21; p < 0.001) respectively, as compared to those patients harbouring c.5882G>A at 0.06 mm/year (95% CI 0.03–0.09), respectively. Future clinical trial design should consider the effect of genotype on the effective radius GR and the timing of DDAF formation relative to symptom onset. [ABSTRACT FROM AUTHOR]

Increasing prevalence of mental health disorders within the Australian population is a serious public health issue. Adequate intake of fruits and vegetables (FV), dietary fibre (DF) and resistant starch (RS) is associated with better mental and physical health. Few longitudinal studies exist exploring the temporal relationship. Using a validated food frequency questionnaire, we examined baseline FV intakes of 5845 Australian adults from the AusDiab study and estimated food group-derived DF and RS using data from the literature. Perceived mental health was assessed at baseline and 5 year follow up using SF-36 mental component summary scores (MCS). We conducted baseline cross-sectional analysis and prospective analysis of baseline dietary intake with perceived mental health at 5 years. Higher baseline FV and FV-derived DF and RS intakes were associated with better 5 year MCS (p < 0.001). A higher FV intake (754 g/d vs. 251 g/d, Q4 vs. Q1) at baseline had 41% lower odds (OR = 0.59: 95% CI 0.46–0.75) of MCS below population average (<47) at 5 year follow up. Findings were similar for FV-derived DF and RS. An inverse association was observed with discretionary food-derived DF and RS. This demonstrates the association between higher intakes of FV and FV-derived DF and RS with better 5 year mental health outcomes. Further RCTs are necessary to understand mechanisms that underlie this association including elucidation of causal effects. [ABSTRACT FROM AUTHOR]